Aggressive care still common for dying seniors

Although fewer Medicare patients died in acute care hospitals in 2009 than in 2000, the number of their trips to the intensive care unit and healthcare transfers increased near the end of life, researchers found.

The percentage of fee-for-service Medicare patients dying at an acute care hospital decreased from 32.6% in 2000 to 24.6% in 2009, while the percentage of patients who died at home increased from 30.7% to 33.5%, according to Joan Teno, M.D., of Brown University in Providence, R.I., and colleagues.

However, rates of hospice use (21.6% in 2000 versus 42.2% in 2009), ICU use (24.3% versus 29.2%), and the average number of healthcare transitions over the last 3 days of life (10.3 versus 14.2) significantly increased over the same period of time, they wrote in the Feb. 6 issue of the Journal of the American Medical Association.

The authors noted that a recent CDC study showed that more patients were able to die at home than in a clinical setting, which implied that patients dying in the U.S. employed more supportive care.

"Although the CDC reports that decedents ages 65 years and older are more likely to die at home, our results are not consistent with the notion that there is a trend toward less aggressive care," they concluded.

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